Journal of Community Health

, Volume 39, Issue 3, pp 572–583 | Cite as

Health Services Use and Prescription Access Among Uninsured Patients Managing Chronic Diseases

  • Jewel Goodman ShepherdEmail author
  • Elizabeth Locke
  • Qi Zhang
  • George Maihafer
Original Paper


Effective chronic condition management is dependent upon prescription medication access and compliance. Impacted access results in increased pain, worsening of the condition and association of additional health-related problems. Prescription medication costs constitute a significant burden for patients who are uninsured and managing chronic conditions. This burden links to the likelihood of medication non-compliance. The purpose of this research was to test the ability of the Andersen Behavioral Model of Health Services Use to examine health behaviors among adult uninsured patients managing physician-diagnosed chronic conditions. To enhance its chronic disease management model for uninsured patients diagnosed with chronic conditions requiring prescription regimens, a local community health center added a pharmaceutical access component to its health care delivery model. The Andersen Behavioral Model of Health Services Use was employed to gain insight on how the predictors of predisposing, enabling and need factors impact the change in clinical outcomes and the number of non-urgent triage telephone encounters, physician visits, and emergency department visits of each uninsured patient diagnosed with a chronic condition requiring prescription medication treatment and receiving care at this facility. Individual health behavior patterns are based on predisposition to care, factors that impede or enable the use of care and overall need for care. In this study, there was a statistically significant relationship between population characteristics and health behavior; between health behavior and outcomes; and between population characteristics and outcomes.


Diabetes Prescription access Uninsured Community health centers 



The authors wish to thank Dean Shelley Mishoe, College of Health Sciences, Interim Chair Dr. Deanne Shuman—School of Community and Environmental Health for their support; and the Office of Graduate Studies for the Old Dominion University Graduate Fellowship Award which supported this work.

Conflict of interest

There were no declared conflicts of interest.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Jewel Goodman Shepherd
    • 1
    Email author
  • Elizabeth Locke
    • 2
  • Qi Zhang
    • 1
  • George Maihafer
    • 2
  1. 1.School of Community and Environmental Health, College of Health SciencesOld Dominion UniversityNorfolkUSA
  2. 2.School of Physical Therapy and Athletic Training, College of Health SciencesOld Dominion UniversityNorfolkUSA

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